The Effects of Catheter Ablation Therapy on Medication Use and Expenditures in Patients with Atrial Fibrillation
**Background:** Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. Catheter ablation has become an important treatment option for many AF patients. Catheter ablation has been hypothesized to reduce the need for continued medical therapy for patients with...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Columbia Data Analytics, LLC
2014-10-01
|
| Series: | Journal of Health Economics and Outcomes Research |
| Online Access: | https://doi.org/10.36469/9881 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823860299985321984 |
|---|---|
| author | Matthew R. Reynolds Guy David Candace Gunnarsson Jamie L. March Steven C. Hao |
| author_facet | Matthew R. Reynolds Guy David Candace Gunnarsson Jamie L. March Steven C. Hao |
| author_sort | Matthew R. Reynolds |
| collection | DOAJ |
| description | **Background:** Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. Catheter ablation has become an important treatment option for many AF patients. Catheter ablation has been hypothesized to reduce the need for continued medical therapy for patients with AF, but there are few empirical data which demonstrate this.
**Objective:** The objective of this study was to estimate the impact of catheter ablation on antiarrhythmic drug (AAD) utilization and total drug expenditures among AF patients.
**Methods:** A retrospective analysis using the Truven Health Analytics MarketScan® Research Database was performed. Patients with AF and a catheter ablation procedure who had continuous enrollment in the database 6 months prior to their first ablation and a minimum of 1-year follow-up post first ablation were compared to AF patients who were treated with AADs and not ablation. Propensity matching was used to account for baseline differences between groups, and multivariable regression models adjusted for patient characteristics and baseline healthcare resource utilization. Sub-analyses were performed for patients age ≥65.
**Results:** AF patients treated with catheter ablation had significantly lower AAD utilization and total prescription drug costs than those treated with AADs only. These results persisted for the subset of patients age ≥65. The effects were strongest in the matched sample, where approximately 30% of ablation patients discontinued use of rhythm medication after receiving catheter ablation. Per-patient total medication expenditures were reduced by $800 to $1,200 per year in the matched sample.
**Conclusion:** Catheter ablation for AF reduced AAD utilization and total prescription drug expenditures in a sustainable fashion up to 3 years post ablation. This reduction was consistent and significant in both the non-Medicare and Medicare populations. |
| format | Article |
| id | doaj-art-a59056e4d8f940be9cffd4c9173965b3 |
| institution | Kabale University |
| issn | 2327-2236 |
| language | English |
| publishDate | 2014-10-01 |
| publisher | Columbia Data Analytics, LLC |
| record_format | Article |
| series | Journal of Health Economics and Outcomes Research |
| spelling | doaj-art-a59056e4d8f940be9cffd4c9173965b32025-02-10T16:13:06ZengColumbia Data Analytics, LLCJournal of Health Economics and Outcomes Research2327-22362014-10-0121The Effects of Catheter Ablation Therapy on Medication Use and Expenditures in Patients with Atrial FibrillationMatthew R. ReynoldsGuy DavidCandace GunnarssonJamie L. MarchSteven C. Hao**Background:** Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. Catheter ablation has become an important treatment option for many AF patients. Catheter ablation has been hypothesized to reduce the need for continued medical therapy for patients with AF, but there are few empirical data which demonstrate this. **Objective:** The objective of this study was to estimate the impact of catheter ablation on antiarrhythmic drug (AAD) utilization and total drug expenditures among AF patients. **Methods:** A retrospective analysis using the Truven Health Analytics MarketScan® Research Database was performed. Patients with AF and a catheter ablation procedure who had continuous enrollment in the database 6 months prior to their first ablation and a minimum of 1-year follow-up post first ablation were compared to AF patients who were treated with AADs and not ablation. Propensity matching was used to account for baseline differences between groups, and multivariable regression models adjusted for patient characteristics and baseline healthcare resource utilization. Sub-analyses were performed for patients age ≥65. **Results:** AF patients treated with catheter ablation had significantly lower AAD utilization and total prescription drug costs than those treated with AADs only. These results persisted for the subset of patients age ≥65. The effects were strongest in the matched sample, where approximately 30% of ablation patients discontinued use of rhythm medication after receiving catheter ablation. Per-patient total medication expenditures were reduced by $800 to $1,200 per year in the matched sample. **Conclusion:** Catheter ablation for AF reduced AAD utilization and total prescription drug expenditures in a sustainable fashion up to 3 years post ablation. This reduction was consistent and significant in both the non-Medicare and Medicare populations.https://doi.org/10.36469/9881 |
| spellingShingle | Matthew R. Reynolds Guy David Candace Gunnarsson Jamie L. March Steven C. Hao The Effects of Catheter Ablation Therapy on Medication Use and Expenditures in Patients with Atrial Fibrillation Journal of Health Economics and Outcomes Research |
| title | The Effects of Catheter Ablation Therapy on Medication Use and Expenditures in Patients with Atrial Fibrillation |
| title_full | The Effects of Catheter Ablation Therapy on Medication Use and Expenditures in Patients with Atrial Fibrillation |
| title_fullStr | The Effects of Catheter Ablation Therapy on Medication Use and Expenditures in Patients with Atrial Fibrillation |
| title_full_unstemmed | The Effects of Catheter Ablation Therapy on Medication Use and Expenditures in Patients with Atrial Fibrillation |
| title_short | The Effects of Catheter Ablation Therapy on Medication Use and Expenditures in Patients with Atrial Fibrillation |
| title_sort | effects of catheter ablation therapy on medication use and expenditures in patients with atrial fibrillation |
| url | https://doi.org/10.36469/9881 |
| work_keys_str_mv | AT matthewrreynolds theeffectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT guydavid theeffectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT candacegunnarsson theeffectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT jamielmarch theeffectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT stevenchao theeffectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT matthewrreynolds effectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT guydavid effectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT candacegunnarsson effectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT jamielmarch effectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation AT stevenchao effectsofcatheterablationtherapyonmedicationuseandexpendituresinpatientswithatrialfibrillation |